Here's why you should stop celebrating the Supreme Court's Obamacare ruling

GlobalPost
Supporters of Obamacare rally outside the Supreme Court after it handed down its decision in favor of the Affordable Care Act.

Making health care more affordable in the United States — and keeping it that way — isn’t easy.

President Barack Obama’s Affordable Care Act (ACA), which the Republicans have vigorously opposed before and since it was signed into law in 2010, survived yet another legal challenge on Thursday when the US Supreme Court ruled 6-3 in favor of nationwide federal subsidies for eligible Americans. 

"Congress passed the Affordable Care act to improve health insurance markets, not to destroy them," Chief Justice John Roberts said.

It was a big decision not only for the future of the ACA, but also for many Americans. Had the ruling gone the other way, by some estimate up to eight million people would have been left uninsured while others would have seen their premiums soar — that's if they could still afford to hang on to their insurance policies. 

Republicans have vowed to keep fighting to dismantle the legislation. 

The ruling offers Americans yet another opportunity to reflect on how health care in the US compares to health care in peer nations. The ACA aims to make health care more affordable and accessible for Americans, but it's not universal and it's not free. It's still a privilege, not a right.

Here are five countries that show just how far the United States has to go when it comes to health care. 

Australia 

 

From the richest to the poorest, all Australians are covered by the country’s public health care system, which costs an estimated $3,997 per capita to fund, or 9.1% of GDP. To ease the burden on public hospitals, the government encourages wealthier people to take out private health insurance by slapping a 1% tax on those earning above a certain income. The system is not 100% perfect or free – patients can wait months for non-emergency procedures and there are out-of-pocket expenses for some doctors and prescription drugs. 

Britain 

 

Britain's National Health Service was launched in 1948 with the aim of providing universal health care services to everyone. Nearly 90 percent of the population uses the public system, which costs an estimated $3,289 per person to maintain, with 10.9 percent covered by private health insurance. People are out of pocket for some services, such as optical and dental, and they end up paying for a handful of prescription items. The UK ranked No. 1 in terms of efficiency in a 2010 Commonwealth Fund study of seven health care systems, but, as you would expect when a service is free, there are wait lists for some specialized procedures. 

France 

 

France's health care system was ranked No. 1 in the world in a controversial World Health Organization report published in 2000.  It's not hard to see why. Like Britain, France provides universal health care to its citizens through a mix of public and private insurance. National health insurance, which covers everyone, even those who have never worked or are illegal immigrants applying for residency, costs an estimated $4,288 per person to fund and it picks up most of the medical bills. Private insurance providers cover other expenses while patients are also required to share the cost of some services, such as visits to the optometrist and dentist and prescription drugs. 

Germany 

 

Universal health care traces its beginnings to Germany, which has been providing medical services to its citizens since the 1880s. About 86 percent of the population mainly relies on the public system for their medical needs, while 11 percent use private health insurance. There are  limits on out-of-pocket expenses, with "cost-sharing" capped at two percent of household income. The public health insurance system is funded through a mixture of public spending and employer and employee contributions, and costs around $4,811 per person to keep going. 

Canada

 

Americans could also consider moving across the border to Canada where the government spends around $4,602 per person a year on providing free access to health care, which covers most things except prescription drugs, dental and optical care. Two-thirds of Canadians also have private health insurance to cover those expenses. 

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